Minimally invasive surgery (MIS) has been developed based on the concept of minimum trauma and maximal function, epitomizing the advancement in modern surgery. Following the introduction of laparoscopy in the 1980s, MIS has continued to evolve into multiple modalities, including single-incision surgery, natural orifice transluminal endoscopic surgery, and robotic surgery. The advancements in imaging, artificial intelligence (AI) and robotization have come together to enhance not only the precision and safety of operations, but also the visualization and technical feasibility even in very complex cases. Numerous investigations have shown that MIS, compared with open surgery, decreases blood loss, reduces complication rates, shortens hospital day, and improves postoperative quality of life. The use of AI has brought surgery to the new age of machine intelligence and data-based decision making. Nevertheless, ethical and legal barriers, inadequate physician training programs, and uneven distribution of resources are obstacles to its wider implementation. The next wave of MIS, will be characterized by intelligence and personalization, incorporating AI navigation, augmented reality, and a multi-disciplinary approach.

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